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AHI from below 5 to 22!
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cmk17 Offline

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Posts: 22
Joined: Jul 2015

Machine: ResMed Airsense 10 Autoset For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: Integrated and heated tube
CPAP Pressure: 8-20
CPAP Software: SleepyHead

Other Comments: Evaluating my treatment using Contec Pulse Oximeter CMS 50D+

Sex: Female
Location: New York, NY

Post: #1
AHI from below 5 to 22!
I have recently switched masks from the wisp to trying both the airfit p10 and the dreamwear. With the p10 my AHI (as reported by my ResMed Airsense 10) was above 5. This morning when using the p10, it was 22!

For the past two nights I have tried using the dreamwear but as the pressure increases through the night, it starts to leak and I can only sleep on my back. So in the morning for the last 2 or 3 hours of sleep, I've changed to the p10.

Here's the problem -- I have sleepyhead software but can't understand how to read the data. I can't figure out what's happening here.

Is there anyone here who can review my data and give me some pointers? Why is my AHI going crazy for just a couple of hours each night? If I could get that under control, I would be so relieved -- but I just don't have the expertise to look at the data set and figure anything out. (I have read the manual for Sleepyhead but can't keep it all in mind as I review my data.)

Thank you in advance for any help you can offer!

Best,
cmk17

___________
"The obscure we see eventually. The completely apparent takes a little longer." Edward R. Morrow
12-05-2015 05:08 PM
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napnaptime Offline

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Posts: 61
Joined: Oct 2015

Machine: Resmed S9 AutoSet with H5i humidifier
Mask Type: Full face mask
Mask Make & Model: Resmed Airfit F10
Humidifier: Yes
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #2
RE: AHI from below 5 to 22!
Make sure the mask doesn't have micro leaks with the cpap running and the mask on run your finger around the seals and if you feel a breeze just lift the mask away from your face and let it snap back in place, it may take a few tries but if it does not work then try a different size.
12-05-2015 05:21 PM
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cmk17 Offline

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Posts: 22
Joined: Jul 2015

Machine: ResMed Airsense 10 Autoset For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: Integrated and heated tube
CPAP Pressure: 8-20
CPAP Software: SleepyHead

Other Comments: Evaluating my treatment using Contec Pulse Oximeter CMS 50D+

Sex: Female
Location: New York, NY

Post: #3
RE: AHI from below 5 to 22!
It looks like I have minimal leaks. I know that the P10 was not leaking. Tonight I thought I'd try a larger size nasal pillow. Maybe that will help.
12-05-2015 06:10 PM
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DeepBreathing Offline
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Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #4
RE: AHI from below 5 to 22!
Quote:Is there anyone here who can review my data and give me some pointers?

If you post a screenshot of your SleepyHead daily screen, somebody will be able to advise. You need to include the section with the pie chart, and the graphs for events, flow rate, pressure, leaks and flow limitations.

DeepBreathing
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www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-05-2015 10:57 PM
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cmk17 Offline

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Posts: 22
Joined: Jul 2015

Machine: ResMed Airsense 10 Autoset For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: Integrated and heated tube
CPAP Pressure: 8-20
CPAP Software: SleepyHead

Other Comments: Evaluating my treatment using Contec Pulse Oximeter CMS 50D+

Sex: Female
Location: New York, NY

Post: #5
RE: AHI from below 5 to 22!

.pdf  CMK Sleepyhead 1.pdf (Size: 198.05 KB / Downloads: 156)
.pdf  CMK Sleepyhead 2.pdf (Size: 193.4 KB / Downloads: 103)
(12-05-2015 10:57 PM)DeepBreathing Wrote:  
Quote:Is there anyone here who can review my data and give me some pointers?

If you post a screenshot of your SleepyHead daily screen, somebody will be able to advise. You need to include the section with the pie chart, and the graphs for events, flow rate, pressure, leaks and flow limitations.

Thanks DeepBreathing.

I attached 2 screenshots where I included just data set recommended. Note that 1. The clock on my ResMed is wrong. Between it being set wrong and daylight savings time; it's off by a few hours. 2. I woke up once and tried to go back to sleep using the DreamWear mask I started with. At the 2nd break in time I switched to the P10 since I couldn't sleep on my side wearing the DreamWear mask.

Any help I can get would be incredibly appreciated.

Sleep well!
cmk17
12-05-2015 11:47 PM
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vsheline Offline

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Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #6
RE: AHI from below 5 to 22!
(12-05-2015 11:47 PM)cmk17 Wrote:  I woke up once and tried to go back to sleep using the DreamWear mask I started with. At the 2nd break in time I switched to the P10 since I couldn't sleep on my side wearing the DreamWear mask.

Hi cmk17,

You think you were awake during all of the 4 hr middle section?

Larger size nasal pillows sometimes helps.

Most of the apneas seem to be scored as Cental Apnea (CA) events, so if you are using EPR you might want to reduce it or turn it off, because doing so often reduces the number of CA events.

Your median pressure appears to have been 10.4. I suggest raising your min pressure, up to perhaps 10 or higher. The machine treats the Min Pressure setting as a target which in the background it slowly lowers the pressure to reach. If the Min Pressure is higher the rate of pressure reduction would be slower, would not drop as quickly, allowing the pressure to be less variable.

You might also try the For Her therapy mode, if you haven't already. The FH mode raises the pressure more slowly and self-adjusts the Min Pressure target higher if it gets two obstructive events too close to each other in time, making the pressure less variable.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-06-2015 12:39 AM by vsheline.)
12-06-2015 12:28 AM
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cmk17 Offline

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Posts: 22
Joined: Jul 2015

Machine: ResMed Airsense 10 Autoset For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: Integrated and heated tube
CPAP Pressure: 8-20
CPAP Software: SleepyHead

Other Comments: Evaluating my treatment using Contec Pulse Oximeter CMS 50D+

Sex: Female
Location: New York, NY

Post: #7
RE: AHI from below 5 to 22!
Thank you vesheline!

I have lowered my EPR to 1. I have tried to use the bigger pillows but find that I have leaks with the small pillows versus the extra small ones. I will try again to see if I can better tolerate them.

I will need to work with my sleep doctor to modify my settings -- even though I know how to do it myself. Both my DME and my doctor get angry when I change the settings. They tell me how it's illegal and a criminal offense (or something like that) to modify the machine without a new prescription. I don't know how to respond to that!

Best,
cml17

___________
"The obscure we see eventually. The completely apparent takes a little longer." Edward R. Morrow
12-18-2015 10:23 AM
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Sleeprider Online
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Posts: 3,363
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #8
RE: AHI from below 5 to 22!
For a new user, your leak rate is very good. Your settings appear to be appropriate to intercept apnea events without ever hitting the maximum pressure, although the machine never settles at the minimum pressure of 8.0. I think a significant portion of the apnea (clear airway) is simply a matter of adapting to therapy and will eventually go away. The change to reduce EPR is a good experiment to see if variable pressure causes CA events; however, they are not that severe, and you may find the comfort of EPR outweighs any small reduction in AHI that you get from the change.

Keep at it, you're doing pretty good from the graphs I'm seeing. If you continue to see the minimum pressure is not useful, then increasing the minimum pressure by 1.0 would not be a bad idea. The larger (small) pillows should actually be more comfortable for you. Most users find they need a larger size than they thought, and very few users actually tolerate the extra small. Notice that your pressure increases are mainly driven by flow limitations, and I suspect a lot of that is related to the extra small pillows.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
12-18-2015 11:19 AM
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cmk17 Offline

Preferred Members

Posts: 22
Joined: Jul 2015

Machine: ResMed Airsense 10 Autoset For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: Integrated and heated tube
CPAP Pressure: 8-20
CPAP Software: SleepyHead

Other Comments: Evaluating my treatment using Contec Pulse Oximeter CMS 50D+

Sex: Female
Location: New York, NY

Post: #9
RE: AHI from below 5 to 22!
Thanks Sleeprider!

I will keep trying the larger (small) pillows. Note that that day was anomalous and that most of my nights are more consistent without the wide range and long middle of the night wakeful time.

I'd like to offer up a more representative night at some point if you have time.

Best,
cmk17

___________
"The obscure we see eventually. The completely apparent takes a little longer." Edward R. Morrow
12-18-2015 11:39 AM
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Sleeprider Online
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Advisory Members

Posts: 3,363
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #10
RE: AHI from below 5 to 22!
Here is an alternative method to post the data. https://sleep.tnet.com/reference/tips/imgur

Your graphs look good, and you're displaying the data we need to see.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
12-18-2015 12:03 PM
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